Healthcare Provider Details

I. General information

NPI: 1063255446
Provider Name (Legal Business Name): CAROLINE GERLACH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2659 STATE ST STE 100
CARLSBAD CA
92008-1627
US

IV. Provider business mailing address

31 CORAL SEA
LAGUNA NIGUEL CA
92677-5949
US

V. Phone/Fax

Practice location:
  • Phone: 866-938-3831
  • Fax:
Mailing address:
  • Phone: 925-918-0896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: